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Previous health/Medicare/prescription claims adjudication experience a plus. Experience with Medicare Supplement preferred. Understand broad strategic concept of our business and link these to the day-to-day business functions of claims processing.
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Experience in Geriatrics patient load and Medicare advantage- Required. Must have experience with Medicare Advantage plans/ patients. Training on Medicare appropriate quality of care (STARS) program.
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Knowledge of long term care regulations/Medicare/Medicaid/Health insurance. The purpose of the Admissions/Marketing Director is to coordinate and perform duties of marketing and communicating the products and services of St. Petersburg Nursing & Rehabilitation Center.
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With a strong insurtech focus, we embrace a broad and innovative approach to serving agents and clients alike. Good PC application skills and typing to 30 wpm with accuracy and clarity of content. Interpret contract benefits in accordance with specific claims processing guidelines.
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The Reporting and Analytics Director - CAHPS/STARS is responsible for high-priority analytical projects for the Medicare CAHPS Organization by leading the planning, direction, and management of resources and efforts of the team to accomplish the company objectives through information management.
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At Pinnacle Home Care, we are more than just a Medicare Certified and Florida Licensed Home Health Company. The Licensed Practical Nurse/Vocational Nurse (LPN) is responsible for providing skilled nursing care under the direct supervision of the Registered Nurse (RN.
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Daily Pay (Work today. They perform selected skilled actions in the provision of curative, rehabilitative, palliative, or preventative nursing care. Graduate of an accredited practical nurse or vocational nursing program.
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Manage and treat geriatric medicare advantage patients 65+ We are looking for a Primary Care Physician for an opportunity at our 65+ over geriatric practice in Hudson, FL. Our ideal candidate will be Board Certified or Board Eligible.
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WHAT WE WOULD LOVE FOR YOU TO HAVE HMO Managed care Medicare Advantage experience. Our commitments to you include: Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs.
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Proficiency in federal and state regulations (DOH, Medicaid/Medicare) and familiarity with third-party payers and managed care principles. Job Summary: As a Utilization Management Nurse/Social Worker, you'll play a crucial role in our multidisciplinary team, ensuring that patients progress seamlessly through their care journey according to appropriate admission statuses.
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2 - 3 years: Two years (three years, if LPN) in long term care and assisted living, including working knowledge of case management/ clinical work, Medicare /Managed care and Managed Medicaid protocols.
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Assist individuals with related matters including eligibility for benefits through Medicaid, Medicare, Social Security, and private insurance. Develop a plan of care for each individual to include services such as advocacy/case management, independent living skills, training, peer support, physical therapy, cognitive therapy, etc.
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Reconcile outstanding pending case requirements and requests for additional information while communicating regularly with our agent.
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Experience in Risk-based arrangements and Value-Based care in government services (Medicare Advantage, Medicaid, ACA)Proven negotiation skills including extensive experience leading Medicare advantage percent of premium/delegation dealsAbility to manage multiple priorities, and leading multiple complex negotiations at a timeAdept at execution and delivery (planning, delivering, and supporting) skillsExperience working in a highly matrixed environment.
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Two years’ experience in a healthcare setting with prior Medicare/Medicaid and third party billing and collections. Minimum of two years experience in an healthcare setting with prior Medicare/Medicaid and third party billing and collections.
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medicare job in Clearwater, FL
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